Kelly Kavanaugh, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17368-NP Issued in OH

Practice address

710A Leona St
Elyria, OH 44035-2349

Phone

(440) 324-0092

Fax

(440) 324-0093

NPI assigned

Jun 11, 2015

Last updated

May 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kelly Norris Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Xcell Medical GroupGroup PAC ID 7416174701, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospitals Ahuja Medical Center Hospital, Beachwood, OH, CCN 360359

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  Medicare reassignment Care Compare group NPD
• Xcell Medical Group

  • Multi-Specialty Clinic/Center
  • Elyria, OH
  • NPI 1295149243
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Hospitals Ahuja Medical Center, Inc

  dba UH Ahuja Medical Center

  • General Acute Care Hospital
  • Beachwood, OH
  • NPI 1609189604
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1609257005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710A LEONA ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352349",
            "telephone_number": "440-324-0092",
            "fax_number": "440-324-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710A LEONA ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352349",
            "telephone_number": "440-324-0092",
            "fax_number": "440-324-0093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Kolbe Rd",
            "address_2": "Suite 209",
            "address_purpose": "LOCATION",
            "city": "Lorain",
            "state": "OH",
            "postal_code": "440531654",
            "country_code": "US",
            "telephone_number": "440-960-3237",
            "fax_number": "440-960-3238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "17368-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "NORRIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenneth John Katricak I, LPC
• Joseph Alec Katrinchak, CRNA
• Mary Ellen Kaucheck, PSY.S.
• Allison E Kaufman, M.ED., L.P.C
• Madison Kauppila, PT, DPT
• Santoshiratnam Kedarsetty, DMD
• Leah Kehler, BA
• Alexzandrea Keil
• Hailey Ann Keller
• Judy Marie Keller

• Family Nurse Practitioner in Elyria, OH
• Providers in Elyria, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.